MME TV Spot

This MME TV spot was created for Sonographers, Radiologists, and advanced practitioners.

This week Julie discusses flow direction and characteristics of the portal and the hepatic veins. In most system settings, a normal main portal vein is displayed in red. This indicates blood flowing toward the liver. However, it is very easy to invert the color map and a normal main portal vein can be displayed in blue. Remember to check your color legend in the upper left hand corner to guide you in your interpretation. Also, flow direction is not all we care about. The size of the main portal vein is important. In portal hypertension you will see an increase in the size of the MPV (greater than 1.3 cm), varices, splenomegaly, ascites, and turbulent hepatic veins are all consequences of portal hypertension. The flow characteristics also tell us about the condition of the liver. Normal portal venous flow should be continuous with slight respiratory variation. Normal venous flow should be more pulsatile with a “tango sign” of 2 steps forward 1 step back. That is flow toward the IVC then reversed flow with the atrial contraction. This particular case study reveals splenomegaly and a MPV measurement of 1.3 cm with normal flow characteristics and direction.